On June 23, the City Children's Hospital ( Ho Chi Minh City) issued a warning about a case of a 16-month-old girl who turned purple and became critically ill about 1 hour after eating crab and spinach soup cooked with well water. Fortunately, the girl was given timely emergency care.
Doctor Nguyen Minh Tien, Deputy Director of the City Children's Hospital, said that on June 17, the unit received a baby girl named PTM (16 months old, residing in Can Duoc district, Long An province) in a state of cyanosis all over her body, with her SpO₂ index (oxygen saturation in peripheral blood) dropping sharply to only 75%.
According to the family, a few hours before, the girl ate crab and spinach soup cooked with well water.
About an hour after the meal, the baby showed signs of being startled, with purple lips and skin, but no coughing or choking. The family quickly took the baby to the City Children's Hospital for emergency care.
At the time of admission, the baby was fussy, had no rash, no fever, no wheezing, no stridor, no vomiting, but showed signs of cyanosis.
Doctors ruled out the possibility of the baby having a foreign body in the airway, and there was no history of drug or food allergies or cardiovascular disease.
Hematocrit and arterial blood gas tests showed severe hypoxia and metabolic acidosis, blood lactate 4.8 mmol/L (normal < 2 mmol/L), liver and kidney function, and electrolytes within normal limits.
Chest X-ray showed no infiltration, heart shadow was not enlarged, echocardiography showed no abnormalities.
Based on clinical symptoms, the child was tested for exposure to air by taking a sample of the child's blood in a capped syringe and shaking it 50 times. The result was that the dark brown color of the blood did not change, and did not turn red as usual.
Doctors diagnosed the baby with methemoglobinemia, which means red blood cells cannot bind with oxygen to turn into red blood.
Immediately, the child was treated with oxygen, an injection of methylene blue antidote, and activated charcoal to remove the poison from the digestive tract. After only 10 minutes, the child's skin began to turn pink again, and 30 minutes later, SpO2 recovered to 95%.
Doctor Nguyen Minh Tien recommends that parents should be careful when using well water for cooking because well water contains a lot of nitrate (NO3-) - an oxidizing agent that changes red blood cells hemoglobin F2+ into F3+, which is unable to bind oxygen to be delivered to body tissues for use, leading to a lack of oxygen causing anaerobic metabolism, increasing blood lactate and metabolic acidosis.
“Parents should use safe tap water when cooking. In particular, some parents also use water boiled from certain vegetables such as amaranth, beetroot, etc. to mix milk for their children because they think it helps replenish blood, but in fact these vegetables have high nitrate content, which can cause methemoglobinemia, especially in premature infants," Dr. Tien advised./.
Source: https://www.vietnamplus.vn/bac-si-canh-bao-vi-sao-nen-can-trong-khi-su-dung-nuoc-gieng-de-nau-an-post1045932.vnp
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